It sounds like a hammer might be coming down very soon, one way or the other.

The FDA is really ratcheting up the rhetoric level against e-cigarettes this week, with FDA Chief Scott Gottlieb saying new data that is soon coming out is showing that the problem of e-cigarette use by teens has grown far worse.

They sound serious. I get a little jaded that the FDA will do anything about nicotine products, but I’ve never seen such strong governmental rhetoric against e-cigarettes before.

FDA Commissioner Scott Gottlieb said the agency will soon release data that show a “substantial increase” in youth vaping this year compared with 2017. He said the problem had reached “epidemic proportion.”

“I have grown increasingly concerned around what we see as rising youth use in these products, and I’m disappointed in the actions the companies have taken to try to address this,” Gottlieb said in an interview.

The FDA told five major e-cigarette manufacturers Wednesday to come up with ways to address youth use in 60 days or the agency could require them to stop selling flavored products that appeal to children. The products being targeted are: Juul, Altria Group Inc.’s MarkTen, Fontem Ventures’s blu, British American Tobacco’s Vuse and Logic.

Whoa, 60 days, so that will be mid-November.

And they’re going after the big boys. Blu, Vuse, MarkTen are about 75 percent of the e-cig market, not counting Juuls.

This new sense of urgency toward e-cigs appears to be driven somewhat by concerns over the exploding use of Juuls. Juuls are a relatively new kind of e-cig that look like a flash drive and are powered by actually plugging them into a laptop computer. They’re incredibly popular with kids.

From the Bloomberg article:

“This could result in a bullet through the head of Juul, the driver of youth initiation,” said Nico von Stackelberg, an analyst with Liberum in London.

To gain clearance to return to the market, the companies would have to prove that the benefits to adults who use e-cigarettes to stop smoking outweigh the risks associated with youth vaping.

“I certainly am in possession of evidence that warrants that,” Gottlieb said. He declined to disclose the evidence.

Of the 3.6 million middle- and high-school students who said in 2017 they are current tobacco-product users, 2.1 million used e-cigarettes, according to the Centers for Disease Control and Prevention.

“There is no question that a lot of the youth use is being driven by Juul,” Gottlieb said.

“Juul was a game changer,” said Matthew Myers of the Campaign for Tobacco-Free Kids. He listed three reasons the company became so successful: It figured out how to deliver high levels of nicotine in a way that wasn’t harsh; it packaged the product in a streamlined, clever way; and it developed a social media and advertising campaign that made a Juul e-cigarette “cool and hip.”

Keep in mind, this issue here isn’t that e-cigs are as bad as cigarettes. But,they are a nicotine-delivery system and they are effectively getting teenagers physically addicted to nicotine. And nicotine addiction is a bad thing in of itself, regardless of the delivery system. And the issue here is e-cig companies have been BRAZENLY marketing e-cig products to kids for years. I know I’ve been railing about it for years.

The issue of Keytruda has become near and dear to my heart the past few weeks with a close family member taking it to treat his lung cancer.

Keytruda is an immunotherapy drug that instead of poisoning the body, uses the body’s own immune system to attack cancer cells. It’s been very effective for melanoma.

Keytruda is sometimes known as “The Jimmy Carter drug.” He is the most famous Keytruda patient. In 2015, Jimmy Carter was diagnosed with inoperable cancer in his brain and liver and was given months to live. Three years later, after being given Keytruda on an experimental basis, he’s still kicking and cancer-free. In fact, now, many cancer patients are left asking their doctors “can I get the Jimmy Carter medication”?

That doesn’t mean Keytruda is some kind of “miracle drug.” It hasn’t worked on everyone. But, after being shown that it was more effective than chemotherapy for melanoma, they started giving it to lung cancer patients.

This is the best description I’ve seen about Keytruda. That it “wakes up” the body’s natural immune system and teaches it to recognize that cancer cells are not normal cells and need to be destroyed.

Keytruda is manufactured by Merck and its chemical name is pembrolizumab. There’s some similar auto-immune cancer drugs, one of which is called Opdivo.

The drug has created so much buzz that it’s gotten attention in L.A. Times articles that it could be a more effective first-line defence against lung cancer than traditional chemotherapy.

Some people call Keytruda a “miracle drug,” but it isn’t quite that. Not yet. It doesn’t cure everyone with melanoma or lung cancer, but apparently it is more effective than traditional chemotherapy. It’s a promising breakthrough. It works fantastic for some people.

Hopefully, immunotherapy will ultimately lead to a total cure for lung cancer.

Another ballot measure to watch. Montana recently put a $2 a pack cigarette tax increase on its ballot to help pay for Medicaid programs. And sure enough, a fishy organization that is quietly funded by RJ Reynolds and Altria is putting out a massive advertising campaign to stop it.

Having lived in Montana for 12 years, I suspect this ballot measure will fail. Montanans are extremely anti-tax. That being said, voters in the state did approve a $1 a pack tax increase about 12, 13 years ago. I was pleasantly surprised that it passed.

That brought Montana’s cigarette tax to $1.70 a pack, which is just below the national average. The raise to $3.70 a pack would be one of the highest taxes in the nation.

This group, called Montanans Against Tax Hikes (notice no mention of that Big Tobacco financing in its name?), is expected to spend up to $680,000 to defeat the measure. According to the Helena Independent, Montanans Against Tax Hikes is almost entirely funded by the makers of Marlboro and Camel. That would be Altria and RJ Reynolds.

That figure compares to $61,000 being spent by proponents of the tax increase. They barely seem to have a chance.

$680,000 sure seems like a lot to defeat a tax measure in a smalls state like Montana, but keep in mind, Big Tobacco spent tens of millions to defeat cigarette tax measures in California (Big Tobacco won the first time, defeating a cigarette tax increase by a few thousand votes, but lost round two, as California raised its cigarette taxes by $2 a pack thanks to a Nov. 2016 ballot measure.)

Probably roughly about 200,000 people in Montana smoke. Say they spend an average of $1,500 a year on cigarettes (that would be just less than a pack a day). It’s believed that every $1 you add to a pack’s cigarette tax drops the smoking rate about 10 percent — so a $2 a pack increase would translate into about 40,000 lost smokers. So 40,000x$1,500xper year = Now you see why Big Tobacco is willing to spend $680,000 to defeat the measure.

The measure would also tax e-cig products for the first time in Montana. The measure goes to a vote in November.

Oooh, I will DEFINITELY be keeping my eye on this one. The Food and Drug Administration is apparently mulling the possibility of banning vaping flavours and is reviewing any regulations that are needed for Juuls, as well.

Juuls are a fairly new type of e-cigarette that doesn’t look like an e-cig at all. It looks like a little flash drive that plugs into a laptop computer … and they DO plug into laptop computers in order to recharge.

Anyway, for now the FDA is doing anything, but will be starting an anti-teen vaping initiative in mid-September.

This month, the FDA asked four e-cigarette companies for information about the appeal of their products to youths and said it could take enforcement action against the companies based on what it learns.

In mid-September, the FDA will launch a vaping prevention campaign targeting 10 million youths who vape or are open to trying it, Scott Gottlieb said. It will continue enforcement against retailers that sell to minors.

“We are very concerned that we could be addicting a whole generation of young people,” Gottlieb said. “We only have a narrow window of opportunity to address it.”

Instead of committing to regulate flavor, the FDA solicited more research on flavor’s role. Robin Koval, CEO of the anti-tobacco group Truth Initiative, said there is ample evidence that flavors attract teens.

USA Today interviewed a bunch of young college students who vaped. The interview that really jumped out at me came from Kevin Kee.

From the article:

Kevin Kee, 22, took up vaping to give up smoking when he was starting college but found himself going back to smoking again when he noticed the Juul was “more ingrained in my life than cigarettes ever were.”

“With the Juul, you can vape anywhere, 24/7. I went through pods way quicker – I could go through a pod in one day,” Kee said. “My tolerance was higher, and I didn’t want that kind of life coming out of college.”

Kee said he thinks people who vape to quit smoking are a minority and most people “vape just to vape.” Out of college and working, he’s given up cigarettes and vaping but fears a flavor ban would really hurt others.

“It’s become so ingrained in our culture that banning flavored nicotine would be like the prohibition,” he said.

People vape just to vape, not to quit cigarettes. I’m all for people using ecigs to get off cigarettes. What I’m not all for is kids 14-, 15-, 16-year-olds becoming addicted to nicotine to begin with via ecigs or Juuls.

Gottlieb also said that the FDA is keeping an eye on Juuls and for its alleged marketing to teens.

Also from the USA TODAY article regarding the controversial and relatively new Juuls:

A class-action lawsuit filed at U.S. District Court in San Francisco by Juul users alleged that the vaping giant used a two-pronged approach to target adult smokers and teens.

One San Diego teen said she was introduced to Juul by eighth-grade classmates. When her device broke last November, she obtained a warranty replacement through Juul’s website even though she was only 14, the lawsuit says.

The lawsuit alleges Juul targeted youth and nonsmokers through ads and “social media blitzes” using “alluring imagery.” Adult smokers were wooed with the promise of a lower or equal amount of nicotine compared with a cigarette even though the product is designed to be more potent and addictive than cigarettes, the lawsuit says.

“On a puff-for-puff basis, this was designed to be more powerful than the gold standard – the cigarette,” said Esfand Nafisi, a San Francisco Bay Area attorney representing Juul users. “That potency was either not disclosed or misrepresented continuously from the time of the company’s inception.”

So, the moral of the story goes … teen smoking has been all but eliminated, but the struggle continues, and likely will always continue as long as nicotine is a legal product and companies are looking to make billions off of it by attracting new users … be it cigarettes, e-cigs or Juuls. I suspect it will be a never-ending battle.

In industry focus groups, some smokers said they thought filters were biodegradable, possibly made of cotton; others said they needed to grind the butts out on the ground, to assure they didn’t set a refuse can afire; others said they were so “disgusted” by the sight or smell of cigarette ashtrays, they didn’t want to dispose of their smokes that way. In one focus group cited in industry documents, smokers said tossing their butts to the ground was “a natural extension of the defiant/rebellious smoking ritual.”

According to this story:

The Ocean Conservancy has sponsored a beach cleanup every year since 1986. For 32 consecutive years, cigarette butts have been the single most collected item on the world’s beaches, with a total of more than 60 million collected over that time. That amounts to about one-third of all collected items and more than plastic wrappers, containers, bottle caps, eating utensils and bottles, combined.

People sometimes dump that trash directly on to beaches but, more often, it washes into the oceans from countless storm drains, streams and rivers around the world. The waste often disintegrates into microplastics easily consumed by wildlife. Researchers have found the detritus in some 70 percent of seabirds and 30 percent of sea turtles.

Actually, I never thought of that before, that the butts are washing into the oceans though sewers.

Anyway, some people are taking an interesting tack on the cigarette butt problem — get rid of cigarette filters altogether.

Yeah, now that you think about it. Why not? It’s been long proven that cigarette butts serve no useful purpose other than trying to trick smokers that their cigarettes have been made safer. No one really buys that anymore, so why keep the filters around. The Truth Initiative has proposed simply getting rid of cigarette filters.

So cigarettes butts continue being a huge pollution problem, despite the precipitous drop in smoking rates in the West.. Anyway, I’ll keep an eye on this campaign to get rid of cigarette butts and see if it goes anywhere.

A couple of contradictory articles here about what appears to be the same survey. Took some research, but I got to the bottom of what these numbers really mean. This CDC graphic is REALLY helpful. I recommend clicking on it to see it full size.

According to U.S. News and World Report, a new Centers for Disease Control survey showed that teen smoking rate has dropped to 9 percent, while teens are also doing fewer drugs, having less sex and … drinking less milk?

OK, the milk part was weird. The point being more kids are drinking sodas and energy drinks.

However, a story from NBC News, which appears to cite the same CDC study, says that teen use of tobacco products has dropped from 24 percent in 2011 to 20 percent today — but that 13 percent of that is from cigarettes, with the rest vaping.

This is mostly good, if not confusing news. Well, more good than bad. I see a glass half-full from the fact that when I started looking at these CDC surveys 10-12 years ago, the teen smoking rate was pushing 30 percent. Now, it’s somewhere between 9-13 percent.

The glass half-empty is that there are still kids getting addicted to nicotine, just from a different delivery system. E-cigs aren’t as bad as cigarettes, but they aren’t 100 percent benign either. It’s best if kids don’t get addicted to nicotine … period. Regardless of the delivery system.

So, I decided to look at the CDC survey directly. I HATE contradictory information like this when different reporters see different results when they look at different part of the same study.

Here’s MY take on the CDC survey (these surveys are done every two years, by the way). A little more in-depth and a little more carefully worded than the two articles:

There is something there that says 8.8 percent of teens have smoked a cigarette in the past 30 days, so that’s where they got 9 percent.

Total number of teens using a tobacco product is 19.6 percent. That’s e-cigs, smokeless tobacco, cigarettes, cigars and hookahs combined.

percentage of kids using e-cigs is 11.7 percent

There is something that says total percentage of “combustible” tobacco products — that’s cigarettes, cigars and hookahs — is 12.9 percent. I’d be willing to bet most “cigars” being smoked by kids are those Swisher Sweets.

So, it appears that both articles are right. It also showed to me that there’s some overlap between kids who smoke and kids that vape — that’s why 11.7 percent + 12.9 percent = 19.6 percent. The articles aren’t clear about that. There is a category in the study that says, “more than two types” of tobacco products. That’s roughly about 10 percent of teens. And that’s why 11.7 + 12.9 = 19.6.

Anyway, the graphic I included with this post makes it MUCH clearer. According to that graphic, the news is generally good, though it could be better.

Teen vaping has actually dropped since it hit its peak in 2014. Yayy, I’m actually heartened by that, though I’d like to see it drop faster. Total nicotine use via either e-cigs or cigarettes has dropped since 2014.

In 2014, roughly 17 percent of teens were using e-cigs, that’s now down below 12 percent.

Total nicotine uses by teens in 2014 was just above 25 percent. That figure is just under 20 percent in 2017. Smoking is down a ton, from about 18 percent (any combustible) in 2014 to 13 percent in 2017. Cigarettes are down from about 11 percent in 2014 to just under 9 percent in 2017.

I don’t know if the CDC broke down the difference between cigarettes and cigars before. I never noticed it before this year’s survey, and I’ve been perusing these CDC survey reports for a decade. But, it’s good to have the whole story. A lot more teens smoking cigars and cigarillos than I thought.

A group is proposing a $2 a pack tax increase to help raise funding for Medicaid in Montana.

For Montana, that is a big tax increase and such a proposal is likely fighting an uphill climb in maybe the most Libertarian state in the country. You might be surprised to know that about 10 years ago, Montana voters did approve a $1 a pack cigarette tax hike. But, times have changed. People have become more extreme in their positions since then.

Anyway, the group behind the measure, Healthy Montana, filed a complaint against a group opposing the measure — Montanans Against Tax Hikes, for illegal campaign behaviour, including not reporting expenditures and making illegal robocalls to Montana voters.

First thing I thought was, “oh, I bet MATH is actually funded by Big Tobacco.”

The complaint says Chuck Denowh, the treasurer for MATH, also filed a letter with the Montana attorney general in April, “opposing the proposed ballot statements for I-185 on behalf of Altria Client Services LLC and Rai Services Company, whose parent companies dominate the tobacco market, controlling roughly 86% of the market share in 2016.”

Sure enough, as we all know Altria is the company formerly known as Philip Morris. And Rai Services Company, I had to Google. It’s the parent company of — you guessed it — RJ Reynolds.

Anyway, this just blew me away, incredibly, one of the robocalls offered people $100 if they called back. I’d love to know if anyone actually received their $100.

Montana’s current tobacco tax is $1.70 a pack, which is almost exactly the national average ($1.68 a pack).

Anyway, in addition to the cigarette tax increase, the proposal would also increase smokeless tobacco taxes by 33 percent and taxes on vaping products. I’ll be keeping on eye on this ballot measure in November. Again, this being Montana, where the sheep are nervous and the taxes are detested, I can’t hold my breath about its chances.

San Francisco voters, by an extremely wide margin, voted during California’s Tuesday election to ban all flavoured tobacco products.

This include sugary cigars, menthol cigarettes and most importantly, sugary- or fruity-flavoured e-cig products. That is a HUGE deal because most e-cig flavours are fruity or sugary.

68 percent voted in favour of the measure. Just 31 percent voted against it.

San Francisco is notoriously one of the most stridently anti-tobacco cities in the country. And get this, RJ Reynolds spent $12 MILLION to try and defeat this measure. Why does RJ Reynolds care so much? In addition to owning Newport menthols, the No. 1 menthol cigarette (Lorillard originally bought out Vuse and then RJR merged with Lorillard), RJ also owns Vuse e-cigarettes, the No. 1 e-cig company in the U.S. (Somewhere along the line, Vuse must have passed Blu).

Anti-tobacco advocates have been trying to get menthol cigarettes banned for a few years, with little luck, no doubt because they’re a huge part of the overall market and are particularly popular with African-American smokers (My parents always smoked menthols when I was a kid). While menthols get a pass from the Food and Drug Administration, the feds a few years ago did ban candy-flavoured cigarettes because they were clearly being directed by tobacco companies toward teen smokers.

And this is the one of the issues with all these fruity and candy-flavoured e-cigarette flavours out there. It’s well-known that teen vaping is way up; more teens vape today than smoke, which is one of the reasons why teen smoking is way down.

This is a good thing … and it isn’t. Kids are still getting addicted to nicotine, they’re just finding a less obnoxious and cheaper delivery system than cigarettes. I’m fine with smokers using e-cigs to get off of cigarettes. I’m not fine with teenagers getting addicted to nicotine to begin with via e-cigs instead of cigarettes. And there’s no way you will convince me that c-cig flavours like strawberry shortcake, bubblegum or smurf grape are actually meant for adults.

“San Francisco’s youth are routinely bombarded with advertising for flavored tobacco and e-cigarettes every time they walk into a neighborhood convenience store. It’s clear that these products with candy themes and colorful packaging are geared towards teens,” the American Lung Association stated.

Patrick Reynolds, the executive director of Foundation for Smokefree America, said that R.J. Reynolds, the tobacco company that his grandfather started, had spent a lot of money fighting the ban because it’s concerned that if it passes in San Francisco, other cities will follow suit.

The company didn’t respond to messages from CNN.

“Big tobacco sees vaping as their future,” Reynolds, an anti-tobacco advocate said. “They are very afraid this is going to pass and if the voters make an informed decision to side with the health community, it will lead to hopefully a tidal wave of cities doing what SF did because the FDA did nothing. We will start to turn the tide against vaping.”

The FDA is warning e-cigarette companies in a letter sent out earlier this month to stop making their products look like candy.

This has been one of the big battles against the fledglinge-cig industry — candy-flavoured products. Candy-flavoured products marketed as candy-flavoured products. And most of all, candy-flavoured products that the industry insists are not designed for underaged users.

Some of these products have names like Smurf Sauce, Twirly Sour Patch kids and Nilla Wafers.

Yeah, this is for real, those are e-cig products on the left.

Are you seriously going to try to convince me that any product with the word “Smurf” in it is actually being marketed to adults?

The Food and Drug Administration and Federal Trade Commission sent 13 letters Tuesday to companies that make and sell the liquids used in e-cigarettes, warning them for using false and misleading labeling and advertising. The nicotine products resemble juice boxes, whip-cream canisters and well-known candy and cookie packages like Sour Patch Kids and Nilla Wafers.

The move follows an FDA sting operation that resulted in 40 warning letters last week to retailers that sold kids Juul e-cigarettes, the latest craze in underage tobacco use.

The FDA has given e-cigarette makers extra time to comply with certain e-cigarette regulations and is attempting to rein in youth use while it learns more about the products. Antismoking advocates have criticized the agency for not moving to ban flavors in tobacco products. FDA Commissioner Scott Gottlieb has said he wants to take a balanced approach to help adults who enjoy the flavors switch from regular cigarettes to vaping.

“Companies selling these products have a responsibility to ensure they aren’t putting children in harm’s way or enticing youth use, and we’ll continue to take action against those who sell tobacco products to youth and market products in this egregious fashion,” Gottlieb said in a statement.

The agency plans “a series of escalating actions” as part of a new plan to prevent youth tobacco use, Gottlieb said.

FDA commissioner Scott Gottlieb, in a telephone briefing with reporters, said that it would be hard for “any reasonable person” to examine the products and not conclude that “they are deliberately being packaged and marketed in a way that is designed to not only be appealing to kids” but also to confuse them by mimicking items they frequently consume.

So, something is supposed to hit the fan within three weeks. I’ll be keeping track of this.

I hate to say it. I try to avoid partisan politics on this page, but I am not a fan of Donald Trump and his administration, but I have to admit, this Scott Gottlieb *appears* to actually take his job seriously. I say “appears” because I am by nature a cynical person and I will await to see if the rubber meets the road with him, so to speak.

But, Jesus Christ on a cracker, e-cig flavours based on Oreo cookies, “Smurf sauce” and “Cookies & Milk” and you’re actually going to sit there with a straight face and try to convince me these are products designed for adults? C’mon!

Seattle joined a list of cities around the country that has banned chewing tobacco at Major League baseball games.

Other cities that have banned chewing tobacco at games are Chicago, New York, Boston, Toronto, San Francisco and Los Angeles. Additionally, California state law prohibits chewing tobacco use at games in Oakland and San Diego.

This means players and coaches can’t chew it on the field and spectators can’t chew it in the stands.

Major League baseball has been urged to ban chewing tobacco. For some odd reason, chewing tobacco use is rampant among ballplayers. The MLB and the player’s union took a somewhat wimpy approach to the issue, banning tobacco use on the field for all incoming players but grandfathering it in for existing MLB players. Which means, eventually it’ll go away, but for the time being you’re still going to see coaches and players chewing on the field.